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Making Progress

机译：取得进展

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摘要

The treatment of anterior cmciate ligament (ACL) injuries in 2019 continues to assure the employment of many sports medicine clinicians. Despite years of research on the mechanism of ACL injury, prevention programs have not made a significant dent in the injury rate. In fact, the youngest athletes in the pediatric and adolescent age groups appear to be more at risk now than ever, possibly because of the increasing influence of sports specialization in soccer and basketball. Even more alarming is the unacceptably high reinjury rate on return to play (RTP) for those who have already persevered through ACL surgery and rehabilitation. The reinjury rate rightly casts doubt on current RTP guidelines and our knowledge base of ACL graft healing and maturation. Recent advances in magnetic resonance imaging suggest that improved postoperative evaluation may not be too far away. Unfortunately, unanswered graft strength questions, along with the unknown physical parameters needed to compensate for modifiable and nonmodi-fiable ACL injury risk factors, keep clinicians guessing about RTP timing. All too often, this decision dilemma comes at the athlete’s expense. All of these daunting, unresolved issues continue to strain sports medical care systems, as fear of posttraumatic osteoarthritis continues to grow. For those clinicians tasked with treating the ACL injury patient, several articles in this issue of Sports Health offer welcome scientific insight. The publication by Ithurburn et al reports the strength and function across maturational levels at RTP after ACL reconstruction. While this article has many limitations, as correctly identified by the authors, it does appear to suggest that the youngest athletes have the most rehabilitation potential. Their better limb symmetry index, hop tests, and International Knee Documentation Committee scores hint at their superior RTP potential, which is similar to the outcome results of Krych et al.
机译：2019年患有前叶韧带（ACL）伤害的治疗继续确保许多体育医学临床医生的就业。尽管对ACL损伤机制有多年的研究，但预防计划并未在伤害率上产生显着的凹痕。事实上，儿科和青少年年龄群体中最年轻的运动员现在比以往任何时候都更加危险，可能是因为体育专业化在足球和篮球中的影响越来越大。更加令人震惊的是，对于已经通过ACL手术和康复已经坚持的人来说，更加令人惊叹的是返回播放（RTP）的高度重新评估率。 Repjury Rate正确地对目前的RTP指南和我们的ACL接枝愈合和成熟的知识基础进行了疑虑。磁共振成像的最新进展表明，改善的术后评估可能不会太远。不幸的是，未解决的移植力强度问题以及补偿可修改和非制导权的ACL损伤风险因素所需的未知物理参数，保持临床医生猜测RTP时间。这一切常见的是，这一决定困境来自运动员的费用。所有这些令人生畏的，未解决的问题仍然继续疲劳，因为恐惧骨髓性骨关节炎的恐惧继续增长。对于那些任务治疗ACL伤害患者的临床医生，在这个体育卫生报告中的几篇文章欢迎科学洞察力。 Ithurburn等的出版物在ACL重建后报告RTP的实力和功能。虽然本文有许多限制，但由作者正确识别，似乎表明最年轻的运动员具有最康复的潜力。他们更好的肢体对称指数，跳跃测试和国际膝关节文件委员会在其优越的RTP潜力中得分暗示，类似于Krych等人的结果结果。

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